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The Role Of N-Acetyl-L-Cysteine (Nac) As An Adjuvant To Opioid Treatment In Patients With Inadequately Controlled Chronic Neuropathic Pain, Thomas B. Moore

Theses and Dissertations

Introduction. While opioid medications are commonly prescribed for management of neuropathic pain (NP), long-term use has been associated with increased risk for overdose, drug interactions and addiction. New strategies are necessary to better manage chronic pain, thereby reducing need for opioid medications and their associated adverse consequences. N-acetyl-L-cysteine (NAC), an over-the-counter supplement, has shown promise in the treatment of psychiatric and addictive disorders. In addition, NAC has shown promise for reducing physiological signs of NP in laboratory rat models, prompting this study.

Purpose. The present study was an open-label clinical trial of NAC as an adjuvant to opioid treatment for …

Examining Ptsd Symptoms And The Effectiveness Of Group Therapy Among African American And Caucasian Veterans, Jennifer A. Coleman

Theses and Dissertations

Millions of Americans have served in the military, and improved survival rates in wars have increased the percentage of those who return home. Posttraumatic stress disorder (PTSD) is one of the most prevalent mental health diagnoses for veterans. Although few studies have examined the link, previous research as well as the minority stress model and transgenerational trauma theories, suggest that race may be associated with PTSD, particularly in military samples. The current study examined whether there were differences in PTSD symptomology (global and symptom cluster-specific) based on veterans’ race and whether group therapy effectively reduced symptoms of PTSD. Data were …

Representativeness Of Patients Enrolled In A Primary Care Clinical Trial For Substance Use Disorders, Sydney S. Kelpin

Theses and Dissertations

Understanding the characteristics of research participants is crucial to ensuring sample representativeness and generalizability of findings to broader patient groups with substance use disorders. Using anonymous computer-administered health survey data, the present study had a unique opportunity to compare patients who chose to participate in an RCT for heavy/problem drinking or drug use (N=713; consenters) with those that chose not to participate (N=625; non-consenters). The sample was 40% male, 76% African American, and had a mean age of 45.2 years. Using multivariate regression, the most parsimonious model found older age, unemployment, prescription misuse, positive screen for drug problems (CAGE), having …

The Influence Of Client-, Family-, And Therapist-Level Pretreatment Characteristics On Therapist Delivery Of Youth Psychotherapy Treatments, Adriana Rodriguez

Theses and Dissertations

The purpose of this exploratory study was to examine the extent to which pretreatment characteristics influence therapist treatment adherence by using data sampled from a randomized effectiveness trial and an efficacy study. Research suggests that youth-, family-, and therapist-level pretreatment characteristics influence therapist behavior; however, this area is underdeveloped as most studies have focused on externalizing problem areas, family-based approaches, and the use of parent or therapist report to assess for therapist adherence. To date, no research has examined this question with anxiety as the target problem, individual-focused CBT, and with observational therapist adherence data. An observational coding measure, Cognitive-Behavioral …

Reciprocal Relations Between Traumatic Stress And Physical Aggression During Middle School, Erin L. Thompson

Theses and Dissertations

There is convincing evidence that demonstrates traumatic stress and aggressive behavior are highly related among adolescents. The evidence is less clear regarding the direction of this relation. The purpose of this study was to examine the reciprocal longitudinal relations between physical aggression and traumatic stress among a predominantly African American sample of middle school students. Support was found for traumatic stress predicting increased levels of physical aggression across the winter to the spring of the sixth grade for boys and across all waves from the fall of the seventh grade to the fall of the eighth grade for both boys …

Evaluating A Brief Web-Based Prevention Intervention For Risky Alcohol Use Among College Students, Zoe Neale

Theses and Dissertations

The purpose of this study was to evaluate a brief, web-based alcohol prevention intervention program as a universal approach to addressing the range of alcohol behaviors present on college campuses. The sample of freshman college students recruited from Spit for Science (Dick et al., 2014) included 153 intervention participants, and 151 control participants matched on demographics and baseline alcohol variables. Hierarchical multiple regression, logistic regression, and moderated multiple regression were used to compare intervention and control participants on post-intervention alcohol variables. Treatment predicted lower alcohol use disorder (AUD) symptoms, particularly among baseline drinkers. For non-drinkers, the intervention was associated with …

Positive Illusory Bias In Adolescents With Adhd: Prevalence, Stability, And Accuracy Of Reporters, Elizaveta Bourchtein

Theses and Dissertations

The positive illusory bias (PIB) – over-reporting levels of self-competence compared to other raters – has been demonstrated in youth with attention-deficit/hyperactivity disorder (ADHD), despite increased impairment rates. However, due to inconsistent definitions of the PIB, conflicting findings have emerged regarding prevalence of the PIB in youth with ADHD and whether parent or child report is actually “biased” and driving the PIB. Additionally, stability of the PIB across time is unknown. The present study used person-centered methodology cross-sectionally and longitudinally to evaluate the prevalence of the PIB in adolescents with ADHD. Results revealed a cross-domain global PIB group at baseline …

Loneliness, Cynical Hostility, And Cognitive Decline In Americans Above Age 50, Sarah C. Griffin

Theses and Dissertations

Background. Research identifies isolation (being alone) as a risk factor for cognitive decline— yet it is possible that subjective dimensions of isolation are more critical. Potential risk factors are loneliness (the distress stemming from feeling alone) and cynical hostility (an attitude of distrust and cynicism). The present study examined the relationship between these factors and cognitive functioning and decline.

Methods. Data came from the Health and Retirement Study, a nationally representative longitudinal study of US adults over 50. Loneliness was measured using the Hughes Loneliness Scale; cynical hostility was measured using items from the Cook-Medley Hostility Inventory. Cognitive functioning was …

Identifying Misconceptions Associated With Inaccurate Survey Reporting In The Combined Use Of Caffeine And Alcohol, Kathryn Polak

Theses and Dissertations

Research on college student use of caffeine combined with alcohol (CAC) and public health concern over such use has been hampered by the absence of psychometrically sound measures of caffeine and CAC use. The present study examined agreement between survey (CAS) and interview (TLFB) methods for collecting data on caffeine, alcohol and CAC use. Participants were N=50 college students randomized to complete CAS followed by TLFB or the reverse. Qualitative follow-up interviews with N=15 participants were used to identify factors contributing to CAS-TLFB discrepancies. Responses varied by method of administration, with largest discrepancy magnitudes found for CAC, followed …

Evaluating The Pennebaker Paradigm With Bereaved Emerging Adults: Applications Of Text Analysis, Elizabeth A. Collison

Theses and Dissertations

Bereavement is an important research area as it can result in grief reactions that lead to serious psychological and health consequences, particularly for the at-risk group of emerging adults (Arnett, 2000; Balk, Walker, & Baker, 2010; Fisher, Murray, & Frazer, 1985; Stroebe, Schut, & Stroebe, 2007). Expressive writing is a well-researched intervention for trauma and adjustment, yet research repeatedly has revealed null results with the classic Pennebaker paradigm as a bereavement intervention (Stroebe et al., 2002; Stroebe, Schut, & Stroebe, 2006). It may be premature, however, to conclude expressive writing is ineffective for the bereaved due to limitations in extant …

The Consequences Of Alcohol Mixed With Energy Drink (Amed) Use In College Students With Attention-Deficit/Hyperactivity Disorder (Adhd), Brooke A. Green

Theses and Dissertations

College students with ADHD, but especially those who consume alcohol, may be at jeopardy for experiencing negative educational and occupational outcomes, problematic substance use, criminal offending, and sexual victimization. Alcohol mixed with energy drink (AmED) use is widespread across college campuses and associated with many of these same problematic outcomes. The risk of experiencing these consequences for college students with ADHD may be exacerbated by AmED use given its unique relationship, above and beyond alcohol use, with these variables. This study sought to examine relationships among GPA, lost work performance, hazardous alcohol use, illicit substance use, criminal offending, and sexual …

Internal And External Validity Of Sluggish Cognitive Tempo In Young Adolescents With Adhd, Zoe Smith

Theses and Dissertations

Adolescents with Sluggish Cognitive Tempo (SCT) show symptoms of slowness, mental confusion, excessive daydreaming, low motivation, and drowsiness/sleepiness. Although many symptoms of SCT reflect internalizing states, no study has evaluated the utility of self-report of SCT in an ADHD sample. Further, it remains unclear whether SCT is best conceptualized as a unidimensional or multidimensional construct. In a sample of 262 adolescents comprehensively diagnosed with ADHD, the present study evaluated the dimensionality of a SCT scale and compared CFA and bifactor model fits for parent- and self-report versions. Analyses revealed the three-factor bifactor model to be the best fitting model. In …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …